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Codes and Terminologies used in Pathology Billing

May 11, 2016

Obtaining timely and accurate pathology reports which further leads to accurate reimbursements is an important role of a pathologist looking after thebilling and coding.

Like other medical specialties, Pathology too requires apt documentation for any medical report. And in the case of additional or reporting services, the documentation should state:

If a separate service was performed.

Which service was it?

What was the specimen?

The number of times the service was performed with each specimen.

Document the stain used and its results.

Document the specific stains and blocks the stains were performed on.

If there wasn't any diagnosis on a specific stain, do not use 'normal' or 'noncontributory.' Use “GMS stain negative for H. pylori” or “Iron stores confirmed by Iron stain.”

Numerous rules and regulations control Pathology billing. It is imperative to be acquainted with and comply with these for an authorized and lucrative result.

A thorough understanding of the codes and terminologies along with the regulations that govern Pathology billing will ensure a smooth billing process and overcome billing challenges, resulting in lesser denials and higher payments.

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